Trusts Obligations to NCCGs

In 2004 Andrew Foster, NHS Human Resources Director, wrote to all NHS Directors of Human Resources in England reminding them of their obligations to NCCGs regarding hours of work, job planning, appraisal, study leave, discretionary and optional points

The BAD sub-committee for NCCGs thought it might be helpful for Dermatology Consultants to know what their Associate Specialist (ASs), Staff Grades (SGs), Clinical Assistants (CAs), Hospital Practitioners (HPs) are entitled to. Hopefully they can then help them to achieve the gold standard

Eligibility / Entry Criteria

§ Associate Specialist

To have completed 10 years medical work since obtaining a primary medical qualification

To have served a minimum of 4 years in the Registrar, Specialist Registrar or Staff Grade, at least 2 of which should have been in Dermatology

Equivalent service can also be acceptable

§ Staff Grade

To have full registration with the GMC.

To have a minimum of 3 years fulltime hospital service in SHO or higher grade since first obtaining full or limited registration, including adequate experience in Dermatology

Equivalent service can also be acceptable

§ Clinical Assistant

No formal requirements are necessary but experience in Dermatology is preferable. Clinical Assistants may or may not be GPs

§ Hospital Practitioner

The grade is open to all Principals in General Practice who have been fully registered for a minimum of 4 years and who fulfil one of the following conditions

a) Two years whole time (or equivalent part time) hospital experience in Dermatology

b) Possession of an appropriate Dermatology Diploma and experience as a Clinical Assistant over a total 5 years

c) Such other experience as is deemed to meet any of the above criteria

Some Trusts make personal arrangements with experienced Non-GP Clinical Assistants and have regraded them to Hospital Practitioner

Regrading

§ See BMA website: www.bma.org.uk for information on regrading

§ See BAD website: www.bad.org.uk (NCCG section – regrading)

Experienced NCCGs will in the future be able to apply to the Postgraduate Medical Education and Training Board for assessment of their training, qualifications and their experience. They may be eligible to go on the Specialist Register straight away or after undertaking top up training

Job Plans

All NCCGs should have an annual job plan meeting (Recommended job description and job plan for AS & SG on RCP Website: >www.rcplondon.ac.uk<.

§ 5 – 7 Fixed sessions are recommended for full time ASs and SGs

§ 2 Flexible sessions are recommended for ASs and SGs employed for 5 sessions

Number of sessions

§ Full time ASs – 11 sessions

§ Full time SGs – 10 sessions

§ CAs / HPs – usually 5 sessions maximum

§ For full terms and conditions of all NCCG grades see BMA website: www.bma.org.uk

Sessional Hours

§ AS 3½ hours

§ CA 3½ hours

§ HP 3½ hours

§ SG 4 Hours

Travelling Time

§ Part time ASs, CAs, HPs are allowed up to ½ an hours travelling time to and from a session which should be allowed for, in their job plan

Clinic size

§ Clinic numbers should not exceed those recommended by BAD – depends expertise, grade and complexity case mix and support staff.

§ Between 8 new or 16 follow ups (or mix) are recommended in the BAD Guidelines for Consultants (Spring 2004) working on their own. An NCCG should not be seeing more patients than this and many should be seeing less

Pay

Rate per session (BMJ June 2004) Annual Rates of Pay

Associate Specialist £58 à £105 £33090 – £60000 (whole time – 11 sessions)

One session = 3½ hours

Staff Grade £57 à £81 £29845 – £42500 (whole time – 10 sessions)

One session = 4 hours

Rate per Notional Half Day, NHD (BMJ June 2004)

Clinical Assistant £78 £4078 per NHD

NHD = 3½ hours

Hospital Practitioner £77 à £103 £3990 – £5377 per NHD

NHD = 3½ hours

The above rates do not include Optional Points (SGs) and Discretionary Points (ASs)

Optional Points for Staff Grades

§ SGs can apply for Optional points when they reach the top of their pay scale. The points are granted on merit and not seniority

§ Trusts should invite all eligible SGs to apply. Most Trusts feel a letter of support from their Consultant is helpful

§ See BMA website: www.bma.org.uk for guidance on applying for Optional Points

Discretionary Points for ASs

§ ASs can apply for Discretionary points when they reach the top of their pay scale. To get the points ASs must show that they are working over and above what is expected of them. They have to compete with other ASs in the hospital

§ Trusts should invite all eligible ASs to apply. Most Trusts feel a letter of support from their Consultant is helpful

§ See BMA website: www.bma.org.uk for guidance on applying for Discretionary Points

Waiting list Initiative (WLI)

§ Experienced NCCGs should be included in WLI clinics if they regularly see new patients

Appraisal

§ See Appraisal Guidance section on BMA website:

§ Annual Appraisal needed by all NCCGs by March 2003 (required for Re-validation). Usually done by Clinical Director or Named Consultant.

§ GP CAs / HPs can be appraised as part of their GP job. Ideally some consideration of their Dermatology CPD needs should be fed into their appraisal process. They can choose to be appraised in their hospital

§ Appraisal Training should be given

§ Time should be given for preparing the Appraisal Folder and filling in the Appraisal forms

Educational meetings

§ NCCGs should be informed of suitable meetings and be encouraged to go. They should have access to a library area that has Dermatology books and Subscription Journals

Continuing Professional Development (CPD)

The current requirement for physicians in the UK are a minimum of 50 educational credits per year, 250 credits over 5 years. This should include 25 non-clinical credits over 5 years. Credits, both Clinical and non-clinical, can be derived from Personal, Internal or External activities. In any one year 25 credits must be External credits (events outside the hospital such as conferences and study days organised by our Conference Unit, national or international meetings, study days; peer review, learning visits and distance learning (however at present the RCP is not approving any web-based learning materials) are also included). No more than 10 Personal credits (where the physician undertakes an individual activity such as carrying out information searches) can be counted towards meeting the scheme’s annual requirement of 50 credits. There is no minimum requirement for Internal CPD (in the doctor's own hospital at teaching events, audit and interdisciplinary meetings)

Study Leave and Expenses

§ NCCGs should be adequately trained and kept up to date

§ Full time ASs and SGs are allowed 30 days Study leave over 3 years. They are entitled to paid study leave and expenses

§ For CAs / HPs, paid Study leave and expenses is at the discretion of the Medical Director. It should be granted as all Doctors require CPD for appraisal and as part of clinical governance

§ Part time doctors should be doing as much CPD as full time. This is obviously difficult to achieve for doctors only doing 1 or 2 sessions a week

§ NCCGs are advised to register their CPD with the RCP

§ The Department of Health states adequate CPD / study leave should be available to all NCCGs

Audit

§ NCCGs need to take part in Audit as it is required for appraisal, revalidation and Clinical Governance

Departmental Meetings

§ NCCGs should be invited to departmental meetings so their opinions are seen to matter

Nursing support

§ NCCGs should have adequate Nursing support so their clinics run efficiently and a chaperone is available

Office Facilities

§ NCCGs should have access to office facilities and to a computer

Secretarial support

§ NCCGs should have good secretarial support so their letters are typed promptly and there is somebody to deal with queries from their patients

Social Events

§ NCCGs should be included in social events so they feel a valued member of their Consultant’s team

Holidays

§ ASs, CAs and HPs are entitled to 6 weeks annual leave

§ SGs are entitled to 5 weeks annual leave in the first two years and then 6 weeks in subsequent years

Disclaimer:

The above is a guide only. Details on these grades often change. The information given should be checked on the BMA and RCP websites (>www.bma.org.uk< and >www.rcplondon.ac.uk<) to ensure it is up to date